Individual
KEVIN KENDZIERSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
35.080641
OH
208D00000X
General Practice Physician
35. 080641
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000213037
ANTHEM
OH
01
—
01973
PARAMOUNT
OH
01
—
080139052
RAILROAD MEDICARE
OH
05
—
104719902
—
MI
05
—
2426860
—
OH
01
—
605424
BUCKEYE
OH
Enumeration date
12/13/2005
Last updated
08/29/2018
Update your record
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